Parasomnier

Parasomnier are a group of sleep disorders characterized by abnormal movements, behaviors, emotions, perceptions, or dreams that occur during sleep, upon falling asleep, or upon waking. They involve partial arousal from sleep and are more common in children, though they can persist or begin in adulthood. Most parasomnias are not dangerous in themselves, but some can lead to injuries or safety concerns if the person acts out Dreams or routines during sleep.

Parasomnias are often divided by the sleep stage at which they occur. NREM parasomnias arise during slow-wave sleep and include somnambulism (sleepwalking), confusional arousals, and night terrors (pavor nocturnus). REM parasomnias occur during rapid eye movement sleep and include REM sleep behavior disorder (acting out dreams) and nightmare disorder. Sleep paralysis, a transient inability to move during transitions between wakefulness and sleep, is commonly listed as a related parasomnia. Other examples occasionally classified as parasomnias include sleep-related eating and certain movement or vocalizations during sleep.

Causes and risk factors include genetics, sleep deprivation, stress, irregular sleep schedules, fever, alcohol or sedative use, certain medications, and underlying neurological or psychiatric conditions. Parasomnias are more likely to occur in children but can affect adults, particularly when sleep quality is poor or when there are coexisting sleep disorders such as sleep apnea.

Diagnosis is typically clinical, based on history and reported episodes. In uncertain cases, polysomnography (overnight sleep study) may be used to observe sleep stages and rule out other conditions. Treatment focuses on safety, good sleep hygiene, and addressing any underlying conditions. Some REM parasomnias respond to melatonin or sedative medications; nightmare disorder may benefit from imagery rehearsal therapy or cognitive approaches.